[Styloid syndrome and its treatment]

Area of Science:

• Otolaryngology
• Neurosurgery
• Vascular Surgery

Background:

• Styloid syndrome, caused by styloid process elongation or stylohyoid ligament ossification, presents with craniocervical pain, dysphagia, and globus sensation.
• Pathophysiology involves irritation of adjacent nerves, the carotid artery, or pharyngeal mucosa.
• Various treatment modalities exist for styloid syndrome.

Purpose of the Study:

• To evaluate the efficacy and safety of a stepwise therapeutic approach for styloid syndrome.
• To analyze outcomes of medical management, transoral styloid fracture, and surgical resection.

Main Methods:

• Retrospective analysis of eleven patients with styloid syndrome.
• Stepwise therapy: initial medical management, followed by surgical intervention if symptoms persist.
• Surgical options included transoral styloid fracture and/or transoral or transcervical styloid shortening/resection.

Main Results:

• Three patients resolved symptoms with medical treatment alone.
• Transoral fracturing succeeded in two of five patients.
• Six patients underwent surgical resection (five transoral, one transcervical), with four achieving symptom resolution and no deficits.
• Two patients experienced severe complications: ipsilateral medial cerebral artery infarction secondary to internal carotid artery dissection or bleeding.

Conclusions:

• A stepwise therapy incorporating medical treatment, transoral styloid fracture, and resection is effective for styloid syndrome.
• Transoral resection is a viable option when the styloid process is submucosal but requires careful consideration of potential severe complications, including internal carotid artery injury.